Imaging of Vascular Wall Fine Structure in the Human Retina Using Adaptive Optics Scanning Laser Ophthalmoscopy

Chui, Toco Y. P.; Gast, Thomas; Burns, Stephen A.

doi:10.1167/iovs.13-13027

Cited by 100 publications

(101 citation statements)

References 65 publications

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“…For measurements of capillary diameter, we used a set of seven healthy control subjects approximately matched in age. For arteriolar wall to lumen ratio comparisons, our technique requires slightly larger blood vessels than the capillaries [42]. For this comparison we used a different group of eight normotensive control subjects.…”

Section: Subjectsmentioning

confidence: 99%

“…This was not possible for capillaries because it was not always possible to image capillary walls (Fig. 2(D), arrow, see ref [28].). Thus, to compare capillary diameters we computed the total diameter of capillaries selected from near the edge of the foveal avascular zone.…”

Section: Vascular Measurementsmentioning

confidence: 99%

“…Flood illuminated AO imaging can show the capillaries and allow quantification [27] but produces relatively low contrasts and is less useful for mapping blood flow. Recently, we have reported that imaging techniques sensitive to lateral scatter can be highly effective for imaging the retinal vasculature [18,28], and this approach has also been useful in measuring RPE cells [12]. However, to date there have not been applications of this approach to studying retinal vascular diseases [27].…”

Section: Introductionmentioning

confidence: 99%

“…However, by using near infrared light to improve retinal penetration [41], along with laser scanning and a confocal aperture to control unwanted scattered light [18,28], retinal microvascular structures can be imaged at high contrast and high resolution by correcting for each subject's individual optics. For retinal vessels that are perfused, the flow of erythrocytes and other cells can be imaged over time [16,17,23] to provide perfusion maps [21,23].…”

Section: Introductionmentioning

confidence: 99%

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In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy

Burns

Elsner

Chui

et al. 2014

Biomed. Opt. Express

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123

139

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Abstract:We used a confocal adaptive optics scanning laser ophthalmoscope (AOSLO) to image the retina of subjects with nonproliferative diabetic retinopathy (NPDR). To improve visualization of different retinal features, the size and alignment of the confocal aperture were varied. The inner retinal layers contained clearly visualized retinal vessels. In diabetic subjects there was extensive capillary remodeling despite the subjects having only mild or moderate NPDR. Details of the retinal microvasculature were readily imaged with a larger confocal aperture. Hard exudates were observed with the AOSLO in all imaging modes. Photoreceptor layer images showed regions of bright cones and dark areas, corresponding in location to overlying vascular abnormalities and retinal edema. Clinically undetected intraretinal vessel remodeling and varying blood flow patterns were found. Perifoveal capillary diameters were larger in the diabetic subjects (p<0.01), and small arteriolar walls were thickened, based on wall to lumen measurements (p<.05). The results suggest that existing clinical classifications based on lower magnification clinical assessment may not adequately measure key vascular differences among individuals with NPDR.

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Section: Subjectsmentioning

confidence: 99%

Section: Vascular Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy

Burns

Elsner

Chui

et al. 2014

Biomed. Opt. Express

Self Cite

123

139

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“…This includes differences in velocity of blood movement in diabetic patients, 73 differences in cone density between patients with and without type I diabetes, 74 and fine alterations in the cellular walls of patients with diabetes. 75 Since AO can be coupled with functional tests with success, 76 this area of research should expand greatly in the future. At this point, these instruments are mostly available in research institutions, but commercially available models are emerging.…”

Section: Adaptive Optics Imagingmentioning

confidence: 99%

Early interventions to prevent retinal vasculopathy in diabetes: a review

Harrison¹,

Yevseyenkov²

2015

OPTO

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Diabetic eye disease is a public health concern in all areas of the world as a leading cause of blindness in the working aged to elderly populations. Diabetes damages the lining of the microvasculature throughout the body through prolonged exposure to hyperglycemic conditions. The ocular changes are progressive with very little recourse for improvement once damage begins. Current treatments for the eye focus mainly on the late stages of the disease when neovascularization or edema threatens sight. Early interventions for diabetic vasculopathy involve metabolic therapy to improve blood glucose and blood pressure control. Technology improvements have a large part to play in advancing diagnosis of diabetic eye disease. These new technologies offer both structural and functional means for assessment of retinal health. This review focuses on current treatments for diabetic eye disease at all stages with an emphasis on new and early interventions. It also details established and emerging technologies used for earlier detection of diabetic eye disease, which is vital to the development and approval of much needed treatments targeted at earlier stages of diabetic retinopathy. Possible future treatments should be aimed to prevent retinal vasculopathy from progressing. This review will explore current research on this topic and what is needed moving forward.

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Severity of arterial defects in the retina correlates with the burden of intracerebral haemorrhage in COL4A1‐related stroke

Ratelade

Mezouar

Domenga-Denier

et al. 2018

The Journal of Pathology

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Mutations in the α1 (COL4A1) or α2 (COL4A2) chains of collagen type IV, a major component of the vascular basement membrane, cause intracerebral haemorrhages with variable expressivity and reduced penetrance by mechanisms that remain poorly understood. Here we sought to investigate the cellular mechanisms of COL4A1-related intracerebral haemorrhage and identify a marker for haemorrhage risk stratification. A combination of histological, immunohistochemical, and electron microscopy analyses were used to analyse the brain parenchyma, cerebrovasculature, and retinal vessels of mice expressing the disease-causing COL4A1 p.G498V mutation. Mutant mice developed cerebral microhaemorrhages and macroscopic haemorrhages (macrohaemorrhages), the latter with reduced penetrance, mimicking the human disease. Microhaemorrhages that occurred in early postnatal life were associated with a transient, generalized increase in blood-brain barrier permeability at the level of capillaries. Macrohaemorrhages, which occurred later in life, originated from deep brain arteries with focal loss of smooth muscle cells. Similar smooth muscle cell loss was detected in retinal arteries, and a time-course analysis of arterial lesions showed that smooth muscle cells are recruited normally in arterial wall during development, but undergo progressive apoptosis-mediated degeneration. By assessing in parallel the extent of these retinal arterial lesions and the presence/absence of macrohaemorrhages, we found that the arterial lesion load in the retina is strongly correlated with the burden of macrohaemorrhages. We conclude that microhaemorrhages and macrohaemorrhages are driven by two distinct mechanisms. Moreover, smooth muscle cell degeneration is a critical factor underlying the partial penetrance of COL4A1-related macrohaemorrhages, and retinal imaging is a promising tool for identifying high-risk patients. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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Imaging of Vascular Wall Fine Structure in the Human Retina Using Adaptive Optics Scanning Laser Ophthalmoscopy

Cited by 100 publications

References 65 publications

In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy

In vivo adaptive optics microvascular imaging in diabetic patients without clinically severe diabetic retinopathy

Early interventions to prevent retinal vasculopathy in diabetes: a review

Severity of arterial defects in the retina correlates with the burden of intracerebral haemorrhage in COL4A1‐related stroke

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